Abstract
Abstract
Context
Depression is common in individuals with cancer and pain, negatively impacts quality of life, treatment adherence, tumor progression, and survival.
Objectives
The primary aims of this study were to (1) evaluate the validity of the Edmonton Symptom Assessment System’s depression (ESAS-D) for detecting major depressive disorder (MDD) as diagnosed by a psychiatrist and (2) identify the best cutoff for this purpose in a sample of cancer pain individuals. The secondary aim was to compare ESAS-D with another commonly used screening measure (Patient Health Questionnaire-2 [PHQ-2]) for classifying individuals as meeting or not meeting Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) criteria for depression.
Methods
49 cancer pain individuals completed the ESAS-D and PHQ-2 Within 2 weeks, a psychiatrist interviewed the participants and determined whether or not they met criteria for MDD based on the DSM-5.
Results
The ESAS-D demonstrated acceptable accuracy and validity for classifying MDD. A cutoff of ≥2 was identified as being best able to balance sensitivity (85%) and specificity (76%) and had an overall accuracy of 79%. A receiver operating characteristic curve analysis showed an area under the curve (AUC) of 0.81 (95% confidence interval [CI]: 0.68–0.94). The ESAS-D also compared favorably with the modified Thai PHQ-2 (sensitivity, 75%; specificity, 72%; overall accuracy, 73%; AUC, 0.74 [95% CI: 0.59–0.88]) for identifying MDD individuals.
Conclusions
The ESAS-D showed acceptable sensitivity, specificity, and overall accuracy for screening for MDD in cancer and pain. It could therefore be used to screen for probable depression in this population.
Publisher
Cambridge University Press (CUP)
Subject
Psychiatry and Mental health,Clinical Psychology,General Medicine,General Nursing
Reference26 articles.
1. Psychological distress and cancer pain: Results from a controlled cross-sectional survey in China;Li;Scientific Reports,2017
2. The Edmonton Symptom Assessment System: Poor performance as screener for major depression in patients with incurable cancer
3. Are cancer pain and depression interdependent? A systematic review
4. “Are you depressed?” Screening for depression in the terminally ill;Chochinov;The American Journal of Psychiatry,1997
5. Prevalence of Depression and Cancer–A systematic review;Riedl;Zeitschrift Für Psychosomatische Medizin Und Psychotherapie,2021